TIDEWATER NEPHROLOGY LTD (NPI# 1467461822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467461822 |
| Entity Type | Organization |
| Organization Name | TIDEWATER NEPHROLOGY LTD |
| Practice Address |
1800 Camelot Dr Suite 401 Virginia Beach VA 23454-2440 |
| Practice Telephone | 7574963706 |
| Practice Fax Number | 7574963715 |
| Mailing Telephone | 7574963706 |
| Mailing Fax Number | 7574963715 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2011-03-09 |
| Authorized Official Name | DAVID WALKER BEST (CEO/PRESIDENT.) |
| Authorized Official Telephone | 7574963706 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
0101027286 | VA | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 0101027286 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | BCBS | BLUE CROSS BLUE SHIE | 01 |
| VA | 006046983 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | TIDEWATER NEPHROLOGY LTD. | 1800 Camelot Drive, Suite 401, Virginia Beach, Virginia 23454 |
| Street Address |
1800 CAMELOT DR SUITE 401 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23454-2440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215921721 | David Walker Best | Internal Medicine | 1800 Camelot Dr, Suite 401, Virginia Beach, VA 23454-2440 | 2005-09-12 |
| 1124473889 | Tal Raizer | Nurse Practitioner | 1800 Camelot Dr, Suite 300, Virginia Beach, VA 23454-2440 | 2016-05-02 |
| 1245587278 | Christina Mccarville Hill | Physical Therapist | 1800 Camelot Dr, Suite 300, Virginia Beach, VA 23454-2440 | 2012-08-09 |
| 1851658819 | Rebecca J Demasi | Physician Assistant | 1800 Camelot Dr, Suite 300, Virginia Beach, VA 23454-2440 | 2012-04-16 |
| 1912297821 | Courtney A Miller | Physician Assistant | 1800 Camelot Dr, Suite 300, Virginia Beach, VA 23454-2440 | 2011-04-12 |
| 1083929491 | Vann Virginia Center for Orthopaedics | Occupational Therapist | 1800 Camelot Dr, Suite 300, Virginia Beach, VA 23454-2440 | 2010-08-10 |
| 1356579957 | Rebecca Mclain Ellis | Physical Therapist | 1800 Camelot Dr, Suite 300, Virginia Beach, VA 23454-2440 | 2009-06-23 |
| 1659523942 | Sentara Medical Group | Psychiatry & Neurology | 1800 Camelot Dr, Suite 201, Virginia Beach, VA 23454-2440 | 2008-10-17 |
| 1053572586 | Andrew B Coulter | Physical Therapist | 1800 Camelot Dr, Suite 300, Virginia Beach, VA 23454-2440 | 2008-06-18 |
| 1326215518 | Blake E Moore | Orthopaedic Surgery | 1800 Camelot Dr, Suite 300, Virginia Beach, VA 23454-2440 | 2008-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356994263 | Agape Consulting | Behavioral Analyst | 1216 Garth Court, Virginia Beach, VA 23454 | 2019-07-19 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1538639158 | Bay Psychiatric II Inc | Counselor | 923 First Colonial Rd Suite 1821, Virginia Beach, VA 23454 | 2018-11-26 |
| 1487151759 | Akanksha Mohan | Student in an Organized Health Care Education/Training Program | 100 Mannng Drive, Chapel Hill, Nc 27514, Chapel Hill, NC 23454 | 2018-04-12 |
| 1275038580 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1615 General Booth Blvd, Virginia Beach, VA 23454 | 2018-03-28 |
| 1346783164 | Tracy Chasse | Occupational Therapy Assistant | 1628 Old Donation Parkway, Virginia Beach, VA 23454 | 2016-11-28 |
| 1982066627 | Jennifer Mitchell | Speech-Language Pathologist | 2101 Agecroft Rd., Virginia Beach, VA 23454 | 2016-03-22 |
| 1659730562 | Rebecca Houvener | Psychologist | 1120 First Colonial Rd Ste 202, Virginia Beach, VA 23454 | 2016-02-19 |
| 1932581741 | Monica Jane Bailey | Nurse Practitioner | 2110 N Great Neck Rd, Virginia Beach, VA 23454 | 2015-06-29 |
| 1376930073 | Ashley A Burkholder | Family Medicine | 1024 First Colonial Rd Ste 104, Virginia Beach, VA 23454 | 2015-04-20 |
| Find all providers in zip 23454 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629422423 | Paris Ethan Pacheco | Internal Medicine | 1168 First Colonial Rd Ste 200, Virginia Beach, VA 23454-2444 | 2016-04-18 |
| 1477991529 | Leonardo Martin Oliva | Internal Medicine | 1060 First Colonial Rd Fl 1, Virginia Beach, VA 23454-3002 | 2013-06-11 |
| 1982940482 | Hilltop Healthcare LLC | Internal Medicine | 2132 Retreat Ct, Virginia Beach, VA 23454-2256 | 2013-01-02 |
| 1992071096 | Ravinderpal K Gill | Internal Medicine | 2901 S Lynnhaven Rd Ste 450, Virginia Beach, VA 23452 | 2012-03-22 |
| 1881962645 | Bert Wellington Holmes IIi | Internal Medicine | 1253 Nimmo Pkwy, Suite 110, Virginia Beach, VA 23456-7782 | 2011-12-08 |
| 1831483445 | Stella Alice Goings | Internal Medicine | 3908 Lake Front Cir, Suite 201, Virginia Beach, VA 23452-2712 | 2011-06-01 |
| 1063722510 | David S Haden Md PC | Internal Medicine | 5505 Indian River Rd Ste 101, Virginia Beach, VA 23464-5252 | 2010-10-18 |
| 1710293212 | Tidewater Integrative Health PC | Internal Medicine | 802 North Newtown Rd, Virginia Beach, VA 23462-1116 | 2010-08-23 |
| 1821316688 | Brian Joseph Lipps | Internal Medicine | 3074 Brickhouse Ct, Virginia Beach, VA 23452-6859 | 2010-05-04 |
| 1851627129 | Amy Marie Goodrich-harris | Internal Medicine | 2008 Winding Lake Ct, Virginia Beach, VA 23456-6305 | 2009-10-21 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23454 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.